MMWR: Implementation of New TB Screening Requirements for U.S.-Bound Immigrants and Refugees–2007-2014

This report summarizes worldwide implementation of new TB screening requirements for foreign-born persons applying for either an immigrant visa or refugee status to enter the United States. In 2007 CDC issued Technical Instructions for Tuberculosis Screening and Treatment Using Cultures and Directly Observed Therapy (CDOT TB TI). The important changes included: sputum cultures in addition to sputum smears; tuberculin skin tests or interferon gamma release assays beginning in 2009 for certain 2-14 year-olds in countries where the World Health Organization estimates TB incidence equal to or greater than 20 per 100,000 persons; drug susceptibility testing of positive isolates; and treatment according to guidelines from the American Thoracic Society, CDC, and the Infectious Diseases Society of America.